QUESTIONS AND ANSWERS

QUESTION

S. P ‘s recent problems relate to teeth cleaning and oral hygiene. For some time we have noticed an increase in irregular and poor teeth cleaning, which must be affecting S.P’s dental care. It is difficult to go to a dentist and now there is the added problem of bad breath. With some saliva control issues the situation appears to be escalating. What can be done?

ANSWER

Take a problem solving and task breakdown approach to identify what aspects to this situation are the priority issues: movements of mouth/tongue; control of hand movements; type of toothbrush and toothpaste being used; loss of usual dental hygiene routine; teeth sensitivity; gum disease; unawareness of oral hygiene, etc.

Obviously the simple solution is to reinstate the usual pattern, but this may not be as easy as it could require introducing behaviour management techniques. Using an electric toothbrush can be a good option. Changing from using toothpaste to dipping the brush into mouthwash may also be partially satisfactory. Going to the dentist for advice and regular teeth cleaning may establish an ongoing dental hygiene service.  The dentist may refer S.P. to a specialist dental service if movements or tooth decay are too big a problem.

Certainly positive management of food residue and bad breath will improve the overall situation for S.P. and you could re-inforce this with positive feedback.

QUESTION

I am the married partner of S P. and just am beginning to realise how the day-to-day demands on me as a carer are increasing.  S.P. stopped working seven years ago.  Because of WINZ policy I choose to keep working and have changed my working hours to allow the best times to be at home with S. P. More and more S P. is doing less and less about the house, which means that I have to do all the jobs as well as provide all care for S.P. I ask myself how long can I keep going as I feel like I will go crazy before too long.  Any suggestions?

ANSWER

It sounds like you have understated the growing problems and the reactions you are feeling.  Carer stress has probably crept up on you and it is okay to say “enough is enough”. At some stage you will need to take stock of your own feelings, needs and capabilities so that you remain healthy: physically, mentally and spiritually. Talk, talk and talk with friends, confidantes, family, HD Field Officer or pastoral chaplain and share what you are experiencing.

Read up on caregiver roles, caregiver rights, stress strategies and coping skills so that you are informed. What you are feeling is well recognised and you can build a team of people and services to share the load (or burden) and to assist you.

It is time perhaps to take more control, to take charge of your own life as well as that of S.P, to acknowledge your abilities and LIMITATIONS and to allow others to share the load of long term extra caring. While this may seem intrusive and a threat to your own privacy or way of life, at some point along the HD journey all couples get to accept the benefits of sharing the caring. You are not alone and you will be learning so many adaptive and positive coping skills. MANAGE STRESS before it manages you.  See also: www.carers.net.nz